Glen Eira City Council
Kindergarten Registration Form

• Registration For 4 Year Old Kindergarten Both 3 and 4 Year Old Kindergarten
• To be eligible for four year old kindergarten children must turn four years of age by 30 April in the year they wish to attend.
  Application Year 2022 2023 2024

• Male Female
• Birth date is outside of range for year selected. Please check birth date/year and then continue.

• Title... Mr Mrs Ms Miss Dr Prof

• Home Phone

  Business Phone

  Mobile Phone

• Email addresses entered must match
• Relationship to child... Father Guardian Mother

• Connection to Council

• Where there is pressure for places, priority will be given to people who live,work or study within City of Glen Eira.

  Are you a City of Glen Eira resident?
  
  Yes No
  Can you demonstrate a connection to the council?
  

  Yes No

• I would like to enter details for a second parent/guardian

• Preference options will be shown once you have selected your Registration type and Registration year

  Please only select preferences you will be willing to accept.

• Kindergartens will provide places for eligible children according to the priority of access criteria in line with the Department of Education and Training guidelines.

• At Risk/Vulnerable/Out of Home Care

• Is the child at risk of abuse or neglect or in out of home care?
  
  Yes No

• Aboriginal Status

• Does your child identify as Aboriginal or Torres Strait Islander?
  
  Select Status Aboriginal but not Torres Strait Islander Origin Both Aboriginal and Torres Strait Islander Origin Neither Aboriginal nor Torres Strait Islander Not stated/inadequately described Torres Strait Islander but not Aboriginal Origin

• Additional Needs of the child

• Does your child have additional needs requirements?
  
  Yes No
• 
  Max 250 characters

• Concession/Visa Cards

• Do you or your child hold a current health care card, concession card, humanitarian/refugee or bridging visa?
  Yes No
• Card Type Commonwealth Health Care Card Commonwealth Pension Concession Card Emergency Rescue Visa (Subclass 203) In-Country Special Humanitarian Visa (Subclass 201) Global Special Humanitarian Visa (Subclass 202) Protection Visa (Subclass 866) Veteran Affairs Gold or White Refugee Visa (Subclass 200) Women at Risk Visa (Subclass 204) Temporary Humanitarian Concern Visa (Subclass 786) Bridging Visa A-E
  
  
  
  
  Proof of Concession Card/Visa:
  JPG or PDF Format. Max 2MB

• Multi Birth

• Is your child a triplet/quad who is attending in the same year as their siblings?
  
  Yes No

• Asylum Seeker

• Are you an Asylum Seeker or Refugee?
  
  Yes No

Additional comments to support your application

By submitting this application the parent/guardian agrees and understands:

• Ensure that all of your child’s immunisations are recorded on the Australian Immunisation Register. If you require assistance with this, please email the Glen Eira City Council immunisation team at immunisation@gleneira.vic.gov.au
• I declare that all the information provided is true and correct and that my child has not or is not currently attending a three or four-year-old kindergarten group.
• This is an application form, not a guarantee of placement. Offers for kindergarten places will be made in the June/July prior to the application year.

• The personal information requested is primarily required to assist in the placement of your child at a kindergarten. This information will be shared with the relevant kindergarten and those directly responsible for the administration of the kindergarten central enrolment system. If you do not provide the information requested, we may not be able to place your child at a kindergarten. You may also be contacted by a surveying consultant on behalf of Council to gather information in order to assess and evaluate kindergarten services provided to the community.
• I have read and understood the privacy statement outlined above.
• If you would like to know more about privacy at Glen Eira City Council, including your right to seek access to any information collected on this form, please contact Council’s privacy officer on 9524 3333.